Letter from the Chief Inspector of General Practice

We carried out an announced comprehensive inspection at Springfield Medical Practice on 26 July 2016. The overall rating for the practice was requires improvement. The full comprehensive report on the July 2016 inspection can be found by selecting the ‘all reports’ link for Springfield Medical Practice on our website at www.cqc.org.uk.

This inspection was an announced focused inspection carried out on 18 July 2017 to confirm that the practice had carried out their plan to address the areas that were rated as requires improvement that we identified in our previous inspection on 26 July 2016. This report covers our findings in relation to those areas and also additional improvements made since our last inspection.

Overall the practice is now rated as good.

Our key findings were as follows:

• The practice had introduced a new system to keep training records under review to ensure staff received refresher training at appropriate intervals. Training records and certificates indicated staff training was up to date. This included training for basic life support (BLS), safeguarding for children and vulnerable adults, moving and handling and equality, diversity and human rights (EDHR).

• Shortly after our inspection on 26 July 2016, the practice had implemented systems for monitoring patients prescribed disease-modifying anti-rheumatic drugs and monitoring responses to safety alerts. We saw evidence the practice had continued to review these areas to ensure they were working effectively.

• The practice had started work to improve patient access to appointments by making changes to the appointment system. They had introduced an enhanced extended hours service by joining the service provided by the local GP federation. However, these improvements had not been reflected in the data gathered for the latest National GP Patient Survey published on 7 July 2017.

• The practice had taken action to identify and register carers so that they may be offered appropriate support. At the time of our inspection on 26 July 2016, 0.6% of patients were registered as carers. During our follow-up inspection on 18 July 2017, we saw the practice had identified 2.6% of the patient list as carers.

• A new range of printed information was available for carers and had been given to all new and existing carers.

• The practice continued to review initiatives to reduce higher than average levels of exception reporting (particularly with mental health related indicators) and these levels had decreased to bring results closer to the local and national averages. For example, the most recently published results (for 2015/2016) demonstrated that exception reporting for mental health related indicators was 13% against a Clinical Commissioning Group (CCG) average of 9% and the national average of 11%. This had improved from 22% for 2014/2015.

However there was an area where the practice still needs to make improvements.

The provider should:

• Continue to take action to improve patient access to appointments.

At our previous inspection on 26 July 2016, we rated the practice as requires improvement for providing responsive services. Patients’ satisfaction with how they could access care and treatment was significantly below local and national averages, although the practice had recognised this and had begun implementing measures to improve. At this inspection we found that patients’ satisfaction in this area had deteriorated further over the subsequent 12 months in spite of the actions the practice had taken so far. The practice is still rated as requires improvement for providing responsive services.

Professor Steve Field CBE FRCP FFPH FRCGP

Chief Inspector of General Practice

This practice is rated as Good overall.

The key questions at this inspection are rated as:

Are services safe? – Good

Are services effective? – Good

Are services caring? – Good

Are services responsive? – Good

Are services well-led? - Good

We carried out an announced comprehensive inspection at Springfield Medical Practice on 26 July 2016. The overall rating for the practice was requires improvement. We then carried out an announced focused inspection on 18 July 2017 to confirm that the practice had carried out their plan to address the areas that were rated as requires improvement that we identified in our previous inspection on 26 July 2016. Following this second inspection, the practice was rated as good, with the responsive domain rated as requires improvement.

This inspection was a desk-based focused inspection carried out on 14 June 2018 to confirm that the practice had carried out their plan to address the areas that were rated as requires improvement that we identified in our previous inspection on 18 July 2017. This report covers our findings in relation to those requirements.

At this inspection we found:

• Urgent same day patient appointments were available when needed.
• Results from the practice’s patient survey revealed a high level of patient satisfaction about the care given at the practice.

The areas where the provider should make improvements are:

• Continue to take action to improve telephone access for patients.

Professor Steve Field CBE FRCP FFPH FRCGPChief Inspector of General Practice

Please refer to the detailed report and the evidence tables for further information.

The figures quoted in the evidence table vary in places from the figures in the previous report due to the new model introduced by CQC for monitoring a range of key indicators for NHS practices, known as GP Insight. More information about GP Insight can be found by following the ‘how we use information’ link in the ‘What we do’ section on our website at www.cqc.org.uk.